Psychology, Emotion, and Pain

Many people who think that they are experiencing an exclusively physical injury are taken back if their doctor of back specialist mention emotion as a factor in their pain experience. People may think, "Why are you mentioning psychology and emotion when I have a physical problem?" While it is true that a patient's experience of back pain may be rooted in a physical problem in the back, it is also true that the way we cope with physical pain may have a large role in how much pain we feel. Psychology, emotion, and pain are three interconnected phenomenon. When we experience anxiety or depression, our immune system plummets, and we are more likely to become sick. When we experience anxiety and depression, our sympathetic nervous system is affected and our heart rate increases, possibly contributing to cardiac problems down the road. It has also been clinically proven that depression and anxiety may cause tension in the muscles which support our necks and backs. Many people believe that Fibromyalgia is a stress-induced medical disorder that causes global muscle tension. Ultimately, emotional and psychological factors have a role in how we experience the world and how our bodies feel. Let's take a closer look at stress-related back pain.

Stress-Related Back Pain: There are those out there, including physicians such as John Sarno, M.D. and Dr. Edward Shorter who believe that our experience of pain is not only influenced by our emotions, but that our emotions are the primary factor in influencing how we feel. Dr John Sarno for his part believes that conditions such as degenerative disc disease, herniated discs, and facet joint arthritis are a rare cause of back pain. Dr. Sarno believes that emotional and psychological factors are the primary factors that cause us to experience pain. Based on this hypothesis, you would believe that for many sufferers of chronic pain conditions, the pain would go away for individuals as soon as the psychological problem was cured. In fact Dr. Sarno does claim this to be the case, as evidenced from his case file collection from his own medical practice. Let's take a closer look at the details.

Doctors such as Mr. Sarno and Mr. Shorter claim that many cases are caused by stress-related back pain. Stress-related back pain is back pain that may be classified as "psycho-physiological" or "psychosomatic". This means that psychological distress is causing a person to have physical distress. The diagnosis of stress-related back pain implies that their physical symptoms are the direct result of negative emotional feelings. Though the cause of the pain is not related to an actual physical problem in the back, the physical pain that is experienced is very real to those that are suffering.

John Sarno M.D. , a medical doctor and professor of physical medicine and rehabilitation at New York University, came up with the medical term "Tension Myositis Syndrome (TMS)" to describe stress-related back pain. Dr. Edward Shorter has also described the stress-related pain phenomenon in his book From Paralysis to Fatigue. This book detailed numerous examples of medical conditions such as chronic fatigue and neurasthenia that were brought on by psychological stress.

While we don't want to suggest to any of our readers that the problem is "all in your head", we would like to make the case that improving your mental health may help your pain condition in several ways.

It is true that the science of medical imaging is improving to the point that we can see every millimeter of the human spine in vivid detail, along with any spinal anomalies that may or may not be present. It is also true that in many patients with back pain, spinal anomalies are found, such as arthritis of the facet joints and herniated discs. Based on the previous two sentences, you may be more likely to believe that the medical imaging results have refuted the fact that stress-related pain is commonly the cause of a patient's symptoms. For patients with pain, the medical imaging results often show obvious pathology to the spine. Case closed, right? Very well, but in studies looking at the medical imaging results of HEALTHY patients, there was also a high rate of medical images that showed the same anatomical anomalies and pathologies.

Let's take a closer look as why stress causes people to experience pain. Assuming that stress is the primary cause of back pain, it is a tricky condition to fix, for several reasons. Imagine that someone who is already in a condition of distress is going to become increasingly more stressed as they experience chronic physical pain. This pain and stress is going to force them to start staying home from work, passing on recreational activities, and to avoid any activities that they may suspect to exacerbate the pain they feel. The pain cycle is characterized by:
  • The experienced pain causes the individual to significantly decrease the amount of activities that they participate in on a weekly basis.
  • This decrease in activities may occur as a result of fear of making the perceived injury from becoming progressively worse.
  • This fear may be made worse by doctors, friends, or family actually encouraging them to take it easy for awhile.
  • The adoption of this physically limiting lifestyle leads to physical de-conditioning and muscle weakness, which both cause the patient's back pain levels to increase.